title: Nutritional supplement usage in patients admitted to a spinal cord injury center.
abstract: OBJECTIVE
  To (1) assess food intake; (2) establish the prevalence of dietary supplement usage and its associated cost (oral nutritional supplements (ONS); vitamin and mineral supplements (VMS)) and; (3) identify the characteristics of nutritional supplement users among patients admitted to a spinal cord injury (SCI) center.
  
  
  METHODS
  A single center survey.
  
  
  METHODS
  Standardized questionnaires were used to collect demographic information, food consumption over a 24-hour period, and the use of nutritional supplements. Multivariate logistic regression was used to determine the characteristics of dietary supplement usage and those using them.
  
  
  RESULTS
  Seventy-three patients with SCI completed and returned the questionnaires (69.5% response rate). From 67 questionnaires with food intake data, 21 patients (31.3%) consumed three full meals a day. Nine of the full 73 patients (12.3%) received artificial nutritional support, 14 of 73 (19.1%) received ONS, 34 of 73 (46.5%) received VMS, and 31 of 73 (42.4%) required assistance in order to eat. The three supplements most often prescribed were multivitamins (19.1%), vitamins B (17.8%), and vitamin D (13.6%). VMS use was associated with age (years: >60 vs. ≤ 60: 62.1 vs. 34.1%, P = 0.019), nutrition risk (Spinal Nutrition Screening Tool (≥ 11 vs. <11: 65.7 vs. 28.9%, P = 0.001), and serum albumin concentration (<35 vs. ≥ 35 g/l: 59.6 vs. 16%, P < 0.01). Patients at nutrition risk were found to consume more ONS than the lower risk group (28.5 vs. 10.5%, P = 0.05). The expenditures on ONS and VMS were higher in the group at greater nutritional risk (£1878.3 vs. £914.3, P = 0.005).
  
  
  CONCLUSIONS
  The use of nutritional supplements is common in patients with SCI, particularly in older adults and patients with poor nutritional state. However, the present study identified only small numbers of patients consuming all of their hospital meals, which may well contribute to undernutrition risk. Given that a high proportion of patients with SCI require assistance to eat, we suggest that further efforts focus on the feasibility of providing feeding assistants, and on reviewing the nature of the hospital menu.
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Bucks, England, UK; School of Health Sciences, City University, London, England, UK; and Centre for Gastroenterology and Clinical Nutrition, University College London Hospital, London, England, UK.
authors.forename: Samford
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Bucks, England, UK.
authors.forename: Allison
authors.initials: A
authors.lastname: Graham
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Bucks, England, UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Green
authors.affiliation: School of Health Sciences, City University, London, England, UK.
authors.forename: Shashivadan P
authors.initials: SP
authors.lastname: Hirani
authors.affiliation: Centre for Gastroenterology and Clinical Nutrition, University College London Hospital, London, England, UK.
authors.forename: Alastair
authors.initials: A
authors.lastname: Forbes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D004032:Diet; D019587:Dietary Supplements / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries; D055815:Young Adult